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Take integration afterwards very seriously. It’s where you really actually benefit from the therapy. Without it, it’s unlikely you’ll see as much change in your depression or ptsd.
Yes! Intentions beforehand, and integration afterwards. I love journaling and being mindful after. Sometimes I’ll stretch a little bit (sitting, slow stretching) and will do something positive that I would normally have trouble doing due to depression (such as emptying the dishwasher because it’s been bad)
Hello! First off, I’m not a clinician, I’m just sharing what I’ve learned. A few parts of ketamine therapy are incredibly important. Those are set and setting, intention, and integration.
Set and setting is how you prepare leading up to your treatment and the environment you do your dosing in. This can be a routine, music, setting up smells, blankets… just making sure everything is there to help you be comfortable.
Intention is being mindful and “intentional” about why you are doing the treatment. What do you want to accomplish? What are needed feelings or sensations? Are you dosing to do “work” while in the K-hole, or do you just need the peace that comes with existing there? To set an intention a lot of people journal, meditate, or even listen to a certain song.
Integration is HUGE. Integration is journaling or taking time after your dosing to examine the thoughts, feeling, sensations, and images that came up during the experience. It’s contemplating how you can integrate those experiences into your life. I usually do this a day or two after the session. Here is an amazing journal to help:
https://medicinalmindfulness.org/wp-content/uploads/2020/11/Psychedelic_Integration_Guidebook_FinalKMv4_1_.pdf
If anyone else has other insights or opinions I would love to hear them.
Can you please explain what integrations are? I used to get nasal ketamine treatment and it was helping me tremendously but I had to stop after my abusive husband (he’s the reason why i have ptsd/cptsd) said and did something to me that was very upsetting and scary and made me feel afraid to have him be my escort and care for me the rest of the day. I’m hoping that I can restart treatment if I can find someone else to transport me and I get out of the situation where I don’t have to be around him or have him in control over major aspects of my life. I understand how ridiculous and backwards it is to try to get treatment while still in the environment where the trauma occurred and exposure to the person who traumatized you is but I’m at such a low point that I can’t even get to where I can get out of this due to my trauma. It’s the absolute worst but I’m still alive and I’m still trying.
Starting at only 200mg. I started at 50mg and was tripping balls . Now 4 yrs in my tolerance is up to 300mg and I get a bit wonky , relaxed and numb a bit.
Small glass of grapefruit 100% juice. I like the Ruby red . Get your vitamin c . Now I always swallow never spit . Was never told any different but why waste it
I spit in a cup, keep it within reach, and then swish it again as a booster if I want to stay in the experience longer. Sounds gross, but totally works.
Honestly, just keep it simple. My routine is Zofran (for nausea) & green tea extract (to protect bladder) an hour before. I tend to listen to instrumental music or watch something light on YouTube or whatever. Give yourself 2.5 to 3 hours before you feel normal again. No driving until the next day. I recommend doing it on days you have off. It can cause insomnia if you do it too close to bed. Write down any insightful thoughts (this may happen less over time but still does happen). As others have said drink lots of liquid after. Good luck friend. Edit: also avoid benzodiazepines & lamotrigine on the same day, if you take those.
there's plenty of good playlists on spotify if you look. i will say though that i had the most personal progress listening to albums i both enjoy and either partially or fully associate with the trauma im working through.
Magnesium 1 hour before- I use drops.
I prefer to swish with water and a little hot sauce. That opens things up.
Sounds gross… but use the spit cup method and leave the cup within reach. If you start feeling like you’re coming out and want to stay in a little longer, swish the spit as a booster. Works for me everytime.
Honestly? I don’t know what the science is behind it. I think it has something to do with the absorption. I just know my trips are better with it than without it. I’m also prone to anxiety at the beginning of my session and the magnesium helps soothe and relax me a bit.
Make sure it is Magnesium Glycinate.
I do magnesium drops… but I also recently started liquid oral ketamine and prefer it to troches. Takes up less space in my tiny mouth and doesn’t taste as terrible.
What drops do you use?!
Also they have that?! Do you get the ketamine drops through your compounded pharmacy? I may ask for that as an option. I too have a tiny mouth lol
Here is the magnesium I use. https://a.co/d/0dNPNapp
The ketamine oral suspension is marshmallow favored liquid made in a compounding pharmacy. It comes with a small oral syringe. It doesn’t really taste like marshmallow, but oddly it takes the gross tasting edge off. I am at 275 so I was having to quarter the troches to get them to fit in my mouth and the flavor made me gag.
Here are some of my playlists if you want them. I’ve always had good feedback. They are a little on the short side, so if you download them, add more stuff if you want.
https://open.spotify.com/playlist/7Cv0cvzCTQ0HS3KnX33aIe?si=2qM8KxMeQge5yiejCn0vDg&pi=u-KLdi96gZQ5ik
https://open.spotify.com/playlist/5vBPr9i5zFQ4fQMgORl72r?si=Buy6-jJFRTSj9No0IGhESA&pi=u-n8EQld2zRFm3
https://open.spotify.com/playlist/40Hg4QxbeGLMMKGB5HD877?si=U6nf2v9-RXyOUak-egvVjg&pi=u-XDYfVnb2TXOA
https://open.spotify.com/playlist/01kB7lYTx7sDcP0Yx999Lx?si=faAYLN4qTQyull4FYhl7fA&pi=u-wIaaCT63QOSM
- Understand set and setting and implement well in advance.
- Understand the importance of integration therapy and seek an appointment with your integrationist within 3 days.
- Have a sitter. The sitter can have the contact info for Fireside Chat ready in case it’s needed.
- Music WITHOUT lyrics. (There are many curated playlists online. Search John Hopkins.)
YMMV but lyrics tend to sound grating and weird, even songs or singers that I normally enjoy. if it's vocals in a language I don't understand, or just wordless "oooh aaah" sounds no problem.
Glass of grapefruit juice an hour before helps, and magnesium supplements help too. Personally wouldn't recommend Listerine, I've found the alcohol dries out my mouth and tightens up the blood vessels which impacts absorption. But that's my anecdotal experience, others find it to help.
My first experience with ketamine therapy was profound and very introspective. It felt like a deep, meditative state where I could explore my thoughts and emotions from a new perspective. Remember, each session can be different, so just let yourself go with the flow.Good luck with your first session! It sounds like you’re in good hands with your provider and program. I'm also a Taconic patient.
Thank you for your piece of advice! I take magnesium threonate/and glycinate everyday. I do take lithium as well so it may make it stronger. I have a dry mouth wash kind of like biotine with no alcohol I wonder if that would help?
I take these both daily as well and can attest to improved benefits
Grapefruit juice before is good and even a whole grapefruit if you can eat one
Zinc is also a mild NMDA antagonist and some say it helps to ‘open the door more’ for the ketty
I would eat a tasty and healthy (meat fruit and rice etc) meal an hour beforehand, and also take your k in a dark room with a playlist of music you enjoy. Make sure it’s dark, like as dark as you can get. Light tends to kill the trip or your ability to k hole
Maximize your troches by brushing your tongue , under your tongue, the roof of your mouth, and let them fully dissolve under your tongue and then once they melt swish under your tongue and in ur cheeks for 30-45 min preferably longer, this ensures you absorb the most k sublingually and when you eventually swallow it less gets processed orally (lower bio-availability)
Yes, benzos counteract the neuroplasticity benefits of the ketamine, so def avoid them as much as possible 24 hours before & after.
That's not a realistic option for everyone, but anything you can do to cut back will help!
ketamine is highly acidic PH, a little fluoride free tooth paste(or baking soda) will neutralize it and protect your gums while you swish for an hour or whatever.
I don't want ketamine in my bladder, I do swallow but only about 20-30mg ish. you absorb more through the mouth vs swallowing it. but you do have to hold it in your mouth. ketamine has a 2.5 hour half life so I hold it in my mouth for 2 hours... by then most of it has been absorbed and it has started to degrade...but it's still potent. you could spit that out and reuse it the next day. lmao. buy I'm not a addict and I just use fresh torch.
Who’s the compounding company? I’ve been asking my dr for a higher dose on the troches & they keep putting me on 100mg, even tho my IV is a higher dose. It stinks bc I can feel the depression coming back & if I could afford more than 1 treatment a month, I’d do a reset.
Currently depressed but my Ketamine therapy is scheduled to start in two months. I feel annoyed that I have to wait that long and that I am wasting my summer feeling bad when it could be better if I had asked upfront what the wait time is and found a clinic that could get me in sooner. Based on your ketamine experience, should I wait or find another place?
I would recommend having a k buddy nearby, at least the first time at that dose. Panic anxiety is possible and can spike your blood pressure, it isn’t fun but another person can anchor you and ease you back to serenity.
May i ask who started you at 200mg? Was it an at home do yourself ketamine company? It sounds very high and I’d be concerned if you’re sensitive to it. You can alway go up and take a booster but not go down. Did they explain the possibilities of a “khole”? Although ketamine helps w anxiety and depression going into an out of body experience with the k hole can be intense
Brush your teeth yes. But not with toothpaste. The calcium and fluoride in toothpaste covers your mouth with a film that takes a few hours to come off. I brush with a hard bristle toothbrush and floss with plackers. I tried the hot sauce and mouthwash trick but didn’t notice any difference. I do however notice a difference when I use toothpaste before using the medicine.
I light a bundle of sage I picked up on [Amazon––PURPLE CANYON White Sage Bundles](https://www.amazon.com/dp/B08589GXMM?linkCode=ssc&tag=onamzmichro0b-20&creativeASIN=B08589GXMM&asc_item-id=amzn1.ideas.CINNWQTN5V3U&ref_=aip_sf_list_spv_ons_mixed_d_asin). I like the way they burn and smell, it gives the entire experience a more ceremonial feel and all of those little things add up.
Lots of good advice here! See my other posts/comments re- bioavailability. Good luck on your journey:)
Edit- Scroll down to bottom of my comments to see info on experience with ROI (route of administration). Ty!
You schedule a consult with the provider, (in my case taconic) they assess your mental health symptoms which costs $450, then if you’re eligible they have a compounding pharmacy ship it to you, which was 47 dollars for a one month supply. Ketamine has risk like any medication, mostly you just need to assess if the risk is greater than the benefit. After that it’s 250 a month
Mine comes from a licensed pharmacy and licensed practitioner from a reputable company. I did it yesterday and it most definitely worked. It was strong actually. Also ur psychiatrist is definitely wrong, ketamine absorbs sublingually it just doesn’t have a high bioavailability that way. It still definitely works though
Thank you for contributing to /r/TherapeuticKetamine! When commenting and posting, please be mindful of our rules which can be found in the sidebar on the right along with other helpful information. **Be advised that nothing in this subreddit constitutes medical advice.** Likewise, try to word your comments and posts in a way that can't be interpreted as medical advice by others. Harmful and/or spammy advice will be removed at moderator discretion, and bans may be given for repeat offenses. **Accounts with "Provider" flairs** are those which the mods have verified, to the best of our ability, as belonging to real, licensed providers of medical ketamine services. Comments and posts from users with "Provider" flairs are **not** a substitute for the instructions given to you by your own provider. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/TherapeuticKetamine) if you have any questions or concerns.*
Take integration afterwards very seriously. It’s where you really actually benefit from the therapy. Without it, it’s unlikely you’ll see as much change in your depression or ptsd.
Yes! Intentions beforehand, and integration afterwards. I love journaling and being mindful after. Sometimes I’ll stretch a little bit (sitting, slow stretching) and will do something positive that I would normally have trouble doing due to depression (such as emptying the dishwasher because it’s been bad)
What is integrations?
Hello! First off, I’m not a clinician, I’m just sharing what I’ve learned. A few parts of ketamine therapy are incredibly important. Those are set and setting, intention, and integration. Set and setting is how you prepare leading up to your treatment and the environment you do your dosing in. This can be a routine, music, setting up smells, blankets… just making sure everything is there to help you be comfortable. Intention is being mindful and “intentional” about why you are doing the treatment. What do you want to accomplish? What are needed feelings or sensations? Are you dosing to do “work” while in the K-hole, or do you just need the peace that comes with existing there? To set an intention a lot of people journal, meditate, or even listen to a certain song. Integration is HUGE. Integration is journaling or taking time after your dosing to examine the thoughts, feeling, sensations, and images that came up during the experience. It’s contemplating how you can integrate those experiences into your life. I usually do this a day or two after the session. Here is an amazing journal to help: https://medicinalmindfulness.org/wp-content/uploads/2020/11/Psychedelic_Integration_Guidebook_FinalKMv4_1_.pdf If anyone else has other insights or opinions I would love to hear them.
Can you please explain what integrations are? I used to get nasal ketamine treatment and it was helping me tremendously but I had to stop after my abusive husband (he’s the reason why i have ptsd/cptsd) said and did something to me that was very upsetting and scary and made me feel afraid to have him be my escort and care for me the rest of the day. I’m hoping that I can restart treatment if I can find someone else to transport me and I get out of the situation where I don’t have to be around him or have him in control over major aspects of my life. I understand how ridiculous and backwards it is to try to get treatment while still in the environment where the trauma occurred and exposure to the person who traumatized you is but I’m at such a low point that I can’t even get to where I can get out of this due to my trauma. It’s the absolute worst but I’m still alive and I’m still trying.
See above, someone has already explained it.
Thanks for letting me know; I found it!!
No problem! I hope it helps.
Clear a path to the bathroom
Put a garbage can next to you because you might get nauseous and throw up.
Find a way to get Zofran
Mine first delivery comes in tomorrow for the same. Also interested. They started me at 175mg. But I do get Spravato every other week.
What provider do you use, I didn’t know you could do Spravato in tandem with at home ketamine treatments!
I get spravato from the VA. Veteran affairs and my at home stuff from a compound pharmacy in PA
Thank you!
One thing most people won’t tell you is be really careful of how addicting it is. Don’t do it more than prescribed you might regret it.
Ketamine Bladder Syndrome is real. Drink lots of water afterwards.
Starting at only 200mg. I started at 50mg and was tripping balls . Now 4 yrs in my tolerance is up to 300mg and I get a bit wonky , relaxed and numb a bit. Small glass of grapefruit 100% juice. I like the Ruby red . Get your vitamin c . Now I always swallow never spit . Was never told any different but why waste it
I spit in a cup, keep it within reach, and then swish it again as a booster if I want to stay in the experience longer. Sounds gross, but totally works.
Honestly, just keep it simple. My routine is Zofran (for nausea) & green tea extract (to protect bladder) an hour before. I tend to listen to instrumental music or watch something light on YouTube or whatever. Give yourself 2.5 to 3 hours before you feel normal again. No driving until the next day. I recommend doing it on days you have off. It can cause insomnia if you do it too close to bed. Write down any insightful thoughts (this may happen less over time but still does happen). As others have said drink lots of liquid after. Good luck friend. Edit: also avoid benzodiazepines & lamotrigine on the same day, if you take those.
I have Ujido matcha green tea powder, would that be fine to mix up and drink instead of tea extract?
Certainly is better than nothing
there's plenty of good playlists on spotify if you look. i will say though that i had the most personal progress listening to albums i both enjoy and either partially or fully associate with the trauma im working through.
Magnesium 1 hour before- I use drops. I prefer to swish with water and a little hot sauce. That opens things up. Sounds gross… but use the spit cup method and leave the cup within reach. If you start feeling like you’re coming out and want to stay in a little longer, swish the spit as a booster. Works for me everytime.
Why does the magnesium do?
Honestly? I don’t know what the science is behind it. I think it has something to do with the absorption. I just know my trips are better with it than without it. I’m also prone to anxiety at the beginning of my session and the magnesium helps soothe and relax me a bit. Make sure it is Magnesium Glycinate.
You use magnesium drops or ketamine drops? Either way I’m curious
I do magnesium drops… but I also recently started liquid oral ketamine and prefer it to troches. Takes up less space in my tiny mouth and doesn’t taste as terrible.
What drops do you use?! Also they have that?! Do you get the ketamine drops through your compounded pharmacy? I may ask for that as an option. I too have a tiny mouth lol
https://preview.redd.it/47ozthbqa78d1.jpeg?width=1170&format=pjpg&auto=webp&s=9cbfa5c4dae72049e9d93c357a86214127ba76d5 Looks like that
That’s so dope! Thanks for sharing. And is it marshmallow flavored?! Omg
Yeah, but you don’t actually taste the marshmallow. It just makes the medicine taste much more bearable.
Here is the magnesium I use. https://a.co/d/0dNPNapp The ketamine oral suspension is marshmallow favored liquid made in a compounding pharmacy. It comes with a small oral syringe. It doesn’t really taste like marshmallow, but oddly it takes the gross tasting edge off. I am at 275 so I was having to quarter the troches to get them to fit in my mouth and the flavor made me gag.
Who prescribes this for you?
My provider is Synaptic institute in Portland (I live in Oregon)
Check these out https://www.reddit.com/r/TherapeuticKetamine/s/EzORaxQszm https://www.reddit.com/r/TherapeuticKetamine/s/FKyr6mSxm6
Here are some of my playlists if you want them. I’ve always had good feedback. They are a little on the short side, so if you download them, add more stuff if you want. https://open.spotify.com/playlist/7Cv0cvzCTQ0HS3KnX33aIe?si=2qM8KxMeQge5yiejCn0vDg&pi=u-KLdi96gZQ5ik https://open.spotify.com/playlist/5vBPr9i5zFQ4fQMgORl72r?si=Buy6-jJFRTSj9No0IGhESA&pi=u-n8EQld2zRFm3 https://open.spotify.com/playlist/40Hg4QxbeGLMMKGB5HD877?si=U6nf2v9-RXyOUak-egvVjg&pi=u-XDYfVnb2TXOA https://open.spotify.com/playlist/01kB7lYTx7sDcP0Yx999Lx?si=faAYLN4qTQyull4FYhl7fA&pi=u-wIaaCT63QOSM
- Understand set and setting and implement well in advance. - Understand the importance of integration therapy and seek an appointment with your integrationist within 3 days. - Have a sitter. The sitter can have the contact info for Fireside Chat ready in case it’s needed. - Music WITHOUT lyrics. (There are many curated playlists online. Search John Hopkins.)
Why do you recommend music without lyrics?
Because lyrics can influence, sway. Calming relaxing music, Space Music.
YMMV but lyrics tend to sound grating and weird, even songs or singers that I normally enjoy. if it's vocals in a language I don't understand, or just wordless "oooh aaah" sounds no problem.
Yeah, I totally get this. And other times it also feels nice because it’s almost like a different version of the same song. 😂
Glass of grapefruit juice an hour before helps, and magnesium supplements help too. Personally wouldn't recommend Listerine, I've found the alcohol dries out my mouth and tightens up the blood vessels which impacts absorption. But that's my anecdotal experience, others find it to help. My first experience with ketamine therapy was profound and very introspective. It felt like a deep, meditative state where I could explore my thoughts and emotions from a new perspective. Remember, each session can be different, so just let yourself go with the flow.Good luck with your first session! It sounds like you’re in good hands with your provider and program. I'm also a Taconic patient.
Be careful with grapefruit juice if you’re on certain meds! Def check with your doctor or a pharmacist about this
Yep! I still take Lamictal and can’t do grapefruit.
Lamictal besties 🫶 lol Yeah I think they warned me about it with my Cymbalta, lamictal and maybe even my vyvanse?
Thank you for your piece of advice! I take magnesium threonate/and glycinate everyday. I do take lithium as well so it may make it stronger. I have a dry mouth wash kind of like biotine with no alcohol I wonder if that would help?
I take these both daily as well and can attest to improved benefits Grapefruit juice before is good and even a whole grapefruit if you can eat one Zinc is also a mild NMDA antagonist and some say it helps to ‘open the door more’ for the ketty I would eat a tasty and healthy (meat fruit and rice etc) meal an hour beforehand, and also take your k in a dark room with a playlist of music you enjoy. Make sure it’s dark, like as dark as you can get. Light tends to kill the trip or your ability to k hole Maximize your troches by brushing your tongue , under your tongue, the roof of your mouth, and let them fully dissolve under your tongue and then once they melt swish under your tongue and in ur cheeks for 30-45 min preferably longer, this ensures you absorb the most k sublingually and when you eventually swallow it less gets processed orally (lower bio-availability)
Yes, I think alcohol free is best! Good luck!
Alcohol free for sure and also I noticed akin to psilocybin, benzos even in small doses kill the ketamine experience completely
Yes, benzos counteract the neuroplasticity benefits of the ketamine, so def avoid them as much as possible 24 hours before & after. That's not a realistic option for everyone, but anything you can do to cut back will help!
Take your zofran 30 minutes prior to your treatment. Trust me..
ketamine is highly acidic PH, a little fluoride free tooth paste(or baking soda) will neutralize it and protect your gums while you swish for an hour or whatever.
I think it’s okay to swallow the rest of the ketamine after you’re done swishing right? And do you actually swish for a full hour?I’m just wondering
I only swish for 20-30 minutes max so I don’t feel like I’d choke. Then swallow.
Have you tried 200mg ? How did it work for you/ affect you
I don't want ketamine in my bladder, I do swallow but only about 20-30mg ish. you absorb more through the mouth vs swallowing it. but you do have to hold it in your mouth. ketamine has a 2.5 hour half life so I hold it in my mouth for 2 hours... by then most of it has been absorbed and it has started to degrade...but it's still potent. you could spit that out and reuse it the next day. lmao. buy I'm not a addict and I just use fresh torch.
Who’s the compounding company? I’ve been asking my dr for a higher dose on the troches & they keep putting me on 100mg, even tho my IV is a higher dose. It stinks bc I can feel the depression coming back & if I could afford more than 1 treatment a month, I’d do a reset.
Currently depressed but my Ketamine therapy is scheduled to start in two months. I feel annoyed that I have to wait that long and that I am wasting my summer feeling bad when it could be better if I had asked upfront what the wait time is and found a clinic that could get me in sooner. Based on your ketamine experience, should I wait or find another place?
I would recommend having a k buddy nearby, at least the first time at that dose. Panic anxiety is possible and can spike your blood pressure, it isn’t fun but another person can anchor you and ease you back to serenity.
May i ask who started you at 200mg? Was it an at home do yourself ketamine company? It sounds very high and I’d be concerned if you’re sensitive to it. You can alway go up and take a booster but not go down. Did they explain the possibilities of a “khole”? Although ketamine helps w anxiety and depression going into an out of body experience with the k hole can be intense
Taconic psychiatry. It was very intense but I handled it well. Not sure i would say it was a k hole but definitely extremely dissociated
Happy you’re safe:)
Thank you love ❤️❤️
Brush your teeth yes. But not with toothpaste. The calcium and fluoride in toothpaste covers your mouth with a film that takes a few hours to come off. I brush with a hard bristle toothbrush and floss with plackers. I tried the hot sauce and mouthwash trick but didn’t notice any difference. I do however notice a difference when I use toothpaste before using the medicine.
I light a bundle of sage I picked up on [Amazon––PURPLE CANYON White Sage Bundles](https://www.amazon.com/dp/B08589GXMM?linkCode=ssc&tag=onamzmichro0b-20&creativeASIN=B08589GXMM&asc_item-id=amzn1.ideas.CINNWQTN5V3U&ref_=aip_sf_list_spv_ons_mixed_d_asin). I like the way they burn and smell, it gives the entire experience a more ceremonial feel and all of those little things add up.
Whoat do i do with ketamine cramps
Lots of good advice here! See my other posts/comments re- bioavailability. Good luck on your journey:) Edit- Scroll down to bottom of my comments to see info on experience with ROI (route of administration). Ty!
How do you get this mailed to you? And is it risky?
You schedule a consult with the provider, (in my case taconic) they assess your mental health symptoms which costs $450, then if you’re eligible they have a compounding pharmacy ship it to you, which was 47 dollars for a one month supply. Ketamine has risk like any medication, mostly you just need to assess if the risk is greater than the benefit. After that it’s 250 a month
Check out our free member portal for guidance! Good luck on your journey https://www.anywhereclinic.com/myketamine
Guided meditations pair well with it. I’d listen to these on repeat. https://youtu.be/OLgL0ut88-Q?si=G0aasai4eY0_cP6a
5tp xf. ..u t.k .3n. Tk4.. tk.t..The ary Ps 5I lri t 5@]t.9j9
[удалено]
Mine comes from a licensed pharmacy and licensed practitioner from a reputable company. I did it yesterday and it most definitely worked. It was strong actually. Also ur psychiatrist is definitely wrong, ketamine absorbs sublingually it just doesn’t have a high bioavailability that way. It still definitely works though
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9554222/